Since the inception of the Comprehensive Sickle Cell Center comprehensive care has been given to adults with clinically significant sickle hemoglobinopathies. The adult patients are assigned to each of three staff physicians who function as a group practice and provide continuity of care . They are assisted by a nurse in the Hematology/Oncology Division and a social worker designated for the Sickle Cell Center. They rotate being attending physician each month for in-patient care. During that month that they are attending physicians for any sickle cell patients that are hospitalized and are consulted by physicians in the Emergency Department when Center patients present. A book in the Emergency Department contains pertinent unique needs for each Center patient as well as recommendations for pain relief. The social worker and research nurse assists in recruiting patients, providing logistical support, and collecting data for research projects in the Project. In addition, a data base is maintained to provide clinical information to investigators. New initiatives are to participate with the Pediatric Clinical Core in a formal transition program whereby adolescent patients are gradually introduced to the adult team through joint pediatric/internal medicine sickle cell clinics. A formal education program will assure that the patients have mastered the cognitive aspects of their disease and will guide them in interacting effectively with the adult care providers. It will also assist them in clarifying lifestyle issues in order to help them lead fulfilled lives.